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API for managing patient insights
This endpoint authenticates clients and provides access tokens for subsequent API calls.
Authentication request body containing client credentials
client_id required | string Unique defined ID for the client |
client_secret required | string Provided client secret information |
grant_type required | string Default: "client_credentials" OAuth 2.0 grant type, must be set to client_credentials |
{- "client_id": "example-client-id",
- "client_secret": "example-client-secret",
- "grant_type": "client_credentials"
}
{- "access_token": "string",
- "token_type": "Bearer",
- "expires_in": 3600
}
Identifies a patient that is eligible to the service by their personal details information.
Authorization required | string Authentication Bearer token to allow request to be processed |
Content-Type required | string Default: application/json Media type of the body of the request |
Patient identification details
first_name required | string Patient's first name |
last_name required | string Patient's last name |
dob required | string <date> Patient's date of birth in yyyy-mm-dd format |
member_id | string [CONDITIONAL] Patient's member ID - At least one of member_id, ehr_id, or zip_code is required |
ehr_id | string [CONDITIONAL] Patient's EHR ID - At least one of member_id, ehr_id, or zip_code is required |
zip_code | string [CONDITIONAL] Patient's ZIP code - At least one of member_id, ehr_id, or zip_code is required |
insurer | string Patient's insurance provider |
state | string Patient's state of residence |
{- "first_name": "John",
- "last_name": "Doe",
- "dob": "1990-07-19",
- "member_id": "123445455",
- "ehr_id": "a1b2c3d4",
- "zip_code": "90210",
- "insurer": "United Health Care",
- "state": "FL"
}
{- "is_eligible": true,
- "patient_id": "d4fon0UkvtdfNBW1JfD5"
}
Retrieving patient care insights for the patient identified in the previous step
Authorization required | string Authentication Bearer token to allow request to be processed |
Content-Type required | string Default: application/json Media type of the body of the request |
Patient identifier
patient_id required | string Unique patient identifier |
{- "patient_id": "d4fon0UkvtdfNBW1JfD5"
}
[- {
- "data_type": "diagnosis_gap",
- "id": "gap1",
- "system": "ICD-10",
- "hcc_model_version": "CMS-HCC V28",
- "medical_codes": [
- {
- "system": "ICD-10",
- "code": "E11.9",
- "description": "Type 2 diabetes mellitus without complications"
}
], - "type": "KNOWN",
- "status": "OPEN",
- "source": "2023 claims",
- "raf_score": 0.368,
- "last_recorded": {
- "date": "2023-09-15",
- "provider": {
- "npi": "1234567890",
- "name": "Jane Smith"
}
}, - "notes": "Example diagnosis gap"
}, - {
- "data_type": "diagnosis_gap",
- "id": "gap2",
- "system": "HCC",
- "hcc_model_version": "CMS-HCC V28",
- "hcc_code": 19,
- "hcc_description": "Diabetes without Complication",
- "medical_codes": [
- {
- "system": "ICD-10",
- "code": "E11.9",
- "description": "Type 2 diabetes mellitus without complications"
}
], - "type": "KNOWN",
- "status": "OPEN",
- "source": "2023 claims",
- "raf_score": 0.104,
- "last_recorded": {
- "date": "2023-10-20",
- "provider": {
- "npi": "0987654321",
- "name": "John Doe"
}
}, - "notes": "Example HCC diagnosis gap"
}, - {
- "data_type": "insight",
- "id": "insught1",
- "code": "CBP",
- "title": "Blood Pressure Check",
- "category": "QUALITY",
- "description": "Annual blood pressure check",
- "type": "HEDIS",
- "medical_codes": [
- {
- "system": "CPT II",
- "code": "3074F",
- "description": "Most recent systolic BP less than 130 mm Hg"
}
], - "status": "OPEN",
- "source": "Quality measure",
- "last_recorded": {
- "date": "2023-09-15",
- "provider": {
- "npi": "1234567890",
- "name": "Jane Smith"
}
}, - "notes": "Annual blood pressure check required"
}
]
Authorization required | string Authentication Bearer token to allow request to be processed |
Content-Type required | string Default: application/json Media type of the body of the request |
Feedback request details - schema varies based on data_type
data_type required | string Type of gaps data - diagnosis_gap or insight |
patient_id required | string The unique ID of the patient |
id required | string The unique ID of the gap selected by the user |
required | object |
required | object |
object | |
object | |
system | string Enum: "ICD-10" "HCC" The main gap system as displayed in the application. |
code | string The original code provided by the customer, which corresponds to the selected code(s) by the user. |
description | string The description of the gap selected by the user. |
type | string Enum: "KNOWN" "SUSPECTED" Indication for a previously known diagnosis or a suspected diagnosis. |
Array of objects The medical code(s) selected by the user with their descriptions. |
{- "data_type": "diagnosis_gap",
- "patient_id": "d4fon0UkvtdfNBW1JfD5",
- "id": "Ae3uywUB0YwdwxxdA4M5",
- "action": {
- "date": "2024-01-20",
- "type": "AGREE",
- "reason": "Confirmed diagnosis",
- "notes": "Patient records show this diagnosis"
}, - "organization": {
- "name": "Test Medical Group",
- "vim_organization_key": "test-medical-key-12345"
}, - "system": "HCC",
- "type": "KNOWN",
- "status": "OPEN",
- "medical_codes": [
- {
- "system": "ICD-10",
- "code": "F32.9",
- "description": "Major depressive disorder, single episode, unspecified"
}
]
}
{- "update_status": "SUCCESS"
}